Should vaccination be mandatory?


Posted by Claire Wright on 20 July 2017

It was recently announced that all parents in France will be legally obliged to have their children vaccinated from 2018.

Mandatory vaccination is something that’s long been debated.

On the ‘pro’ side are those who say that legislation has had a dramatic effect in other areas of public health and safety (such as the indoor smoking ban, and use of seatbelts) so why not do the same with immunisation?

Others are more reserved however, expressing concerns that there is a lack of evidence that mandatory vaccination actually helps to increase uptake. 

Why should vaccines be mandatory?

Vaccination is one of the most effective public health interventions in the world for saving lives and promoting good health. Only clean water, which is considered to be a basic human right, performs better.

Despite this, uptake of vaccines has reduced in some countries and this is thought to be partly caused by misguided concerns over vaccine safety.

When vaccines control disease, parents are less likely to witness the devastating effects of vaccine preventable infectious diseases first hand. It is then easy for misplaced anxiety or suspicion about vaccines to override concerns about the disease itself.

When vaccination rates decline, we start to see a resurgence of infectious diseases.

That’s why some countries are choosing to make vaccination mandatory. However, the effectiveness of this approach varies in countries which have already implemented it.

What do we know about mandatory vaccination so far?

In all 50 US states it is mandatory for children over five to receive vaccinations prior to enrolment in state licensed public schools, and often private schools or day care facilities. All states have exemptions on medical grounds, almost all states grant religious exemptions and only a few states allow philosophical exemptions for those who object to immunisations because of personal, moral or other beliefs.

Rates of exemptions have increased in recent years and studies have shown that vaccine exemptions tend to cluster geographically, leaving some communities at greater risk for disease outbreaks.

Additionally it seems that some parents delay vaccinating their children until they start school. This is not ideal because babies are much more vulnerable to the diseases for which vaccines are scheduled in the first year of life. They need that protection early.

There has also been an increase in rates of home schooling which is speculated could be an unintended consequence of the legislation.

In US states with the strictest laws, the rates of whooping cough and measles are significantly lower, which suggests that if exemptions are harder to come by then mandatory vaccination may be more effective.

In Australia a requirement for children to meet immunisation schedules has for a long time been attached to childcare payments. In an attempt to further improve vaccination rates, exemptions were removed as of January 2016. Six months later it was reported that more than 148,000 children who had not been up to date with their immunisations met their requirements as a result.

Is there a better way?

Making vaccination compulsory is not the only way to obtain high vaccination rates. The UK has held an enviably high uptake rate for many years with the vast majority of parents choosing to vaccinate their children.

Research into how to further improve uptake rates amongst vaccine hesitant parents suggests that talking concerns through with a trusted health professional is beneficial. Additionally, practical issues such as making sure that vaccines and health care are easy to access is essential. Many families who don't vaccinate are not averse to it but simply have difficulty getting convenient appointments or don’t get reminders when their children are due vaccines.

Perhaps making vaccination a core part of the educational curriculum could help future generations be less hesitant to vaccinate.

One thing we know for sure is that meningitis and septicaemia are deadly diseases that strike without warning, and vaccination has proved to be the only way to prevent it.

Whether mandatory vaccination is the best way to achieve high uptake of vaccines remains under debate. The impact this has in France will be of great interest.

About the Author

Claire Wright
Evidence & Policy Manager (Prevention)
My name is Claire and my role as Evidence & Policy Manager (Prevention) involves working on the educational materials that MRF distributes to health professionals and the public, making sure that it is up to date with findings from current research.

I also try to answer specific medical questions we receive about meningitis and septicaemia and promote the charity's work at conferences around the country.

It’s very rewarding to work on awareness literature which may go on to help save lives and support those who have been affected by this disease.


Posted on 16 August 2017

Comment by Wendy Stephen

A more receptive and responsive Vaccine Damage Payment Scheme in the UK which actually does what the name implies in awarding payment to ALL acknowledged vaccine damaged applicants, not just those deemed by DWP appointed advisors to be over the 60% disablement threshold, might just make parents think more favourably towards vaccination. Presently it is more likely than not that claims will be refused and the current provisions in the Vaccine Damage Payment Act 1979 allow for vaccine damaged children to be denied financial assistance if, in the view of the assessors, they are not damaged enough.

No amount of financial assistance will return to the applicant what they have lost through vaccination but it can lighten the burden for both the applicant and the families left caring for the injured child.

The public might be encouraged to accept vaccination, avoiding mandatory vaccination, if they were reassured that in the event that something goes wrong, and causation is established between the vaccine and the condition complained of, they will be awarded financial help. Sadly, from personal experience, that is currently far from the case.

Posted on 02 August 2017

Comment by Barbara Thompson

I think all meningitis vaccines should be mandatory whether it be the men B or the Men W. We lost our grandson 10 months ago to meningitis septecemia type W. All children and teenagers should recieve all vaccines.

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